Provider Demographics
NPI:1669058129
Name:KB RAPID LAB LLC
Entity type:Organization
Organization Name:KB RAPID LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:RODRICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:PBT(ASCP)
Authorized Official - Phone:859-270-8680
Mailing Address - Street 1:1608 KONNER WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-1182
Mailing Address - Country:US
Mailing Address - Phone:859-270-8680
Mailing Address - Fax:
Practice Address - Street 1:1608 KONNER WOODS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1182
Practice Address - Country:US
Practice Address - Phone:859-270-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty